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Pharm Exam II > Adrenergic and Cholinergic Drugs > Flashcards

Adrenergic and Cholinergic Drugs Flashcards

1
Q

Function of the Autonomic Nervous System

A

Responsible for controlling involuntary body functions: BP, digestion, elimination, thermoregulation

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2
Q

What are the two parts of the ANS?

A
  1. sympathetic nervous system
  2. parasympathetic nervous system
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3
Q

What does sympathetic innervation cause?

A

-increase in CO (increased HR and heart contractility)
-decreased visceral blood flow (to allow blood flow to skeletal mm)
-peripheral vasoconstriction
-increased cellular metabolism
-bronchial relaxation (decreased airway resistance)
-increases release of epinephrine and NE (fight or flight) = increases cardiac function

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4
Q

What does parasympathetic innervation cause?

A

-slows HR and heart contractility
-increases intestinal digestion and absorption
-bronchial constriction (increased airway resistance)
-peripheral vasodilation

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5
Q

What are the two neurotransmitters involved in the ANS?

A
  1. Acetylcholine- cholinergic
  2. Norepinephrine- adrenergic
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6
Q

What are the two categories of Cholinergic Receptors?

A
  1. Nicotinic
  2. Muscarinic

**both bind with acetylcholine, but they have different affinities

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7
Q

What are the 5 categories of Adrenergic Receptors?

A
  1. Alpha-1: found in smooth mm
  2. Alpha-2: decreases release of NE
  3. Beta-1: found in heart and kidneys
  4. Beta-2: found in smooth mm, bronchioles, uterus, and bladder
    5: Beta-3: found in adipose tissue, heart, and bladder
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8
Q

What do drugs within the ANS work?

A

They will either stimulate or block a specific subtype of cholinergic or adrenergic receptors

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9
Q

What is the purpose of Cholinergic Drugs?

A

To alter the response of many different tissues to parasympathetic control by affecting the activity at cholinergic synapses

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10
Q

What are the different types of Cholinergic Stimulants?

A
  1. Direct acting stimulants: binds to cholinergic receptors to activate it
  2. Indirect acting stimulants: increase activity at cholinergic synapses by inhibiting the acetylcholinesterase enzyme
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11
Q

What does acetylcholinesterase do?

A

It is an enzyme that destroys acetylcholine- the purpose of indirect acting cholinergic stimulants is to inhibit this enzyme so it will allow more acetylcholine to remain at the synapse

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12
Q

What are cholinergic stimulants used for?

A
  1. Alzheimer Disease
  2. GI and bladder issues
  3. Glaucoma
  4. Myasthenia Gravis
  5. Neuromuscular blockage
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13
Q

Adverse effects of Cholinergic stimulants

A

-GI distress
-increased salivation
-bronchoconstriction
-bradycardia
-difficulty visual accommodation
-increased sweating

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14
Q

What is the purpose of Anticholinergic Drugs?

A

To diminish the effects to cholinergic stimulation

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15
Q

What are the two categories of anticholinergic drugs?

A
  1. Antimuscarinic drugs
  2. Antinicotinic drugs
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16
Q

Uses of Antinicotinic Drugs

A

-very specific for nicotonic receptors in the autonomic gangila
-used to treat HTN and blocks the skeletal neuromuscular junction
-used with anesthesia

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17
Q

Uses of Antimuscarinic Drugs

A

-Primarily used for GI disorders
-maybe used for PD
-Cardiovascular system (treats bradycardia)
-Motion sickness
-Preoperative medications (decreases respiratory secretions
-Urinary Tracts (alleviate urinary frequency and incontinence)
-Respiratory Tract (vasoconstriction)
-Eyes (pupil dilation)

**more commonly used than antinicotinic drugs

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18
Q

Side effects of Anticholinergic drugs

A

-dry mouth
-blurred vision
-urinary retention
-constipation
-tachycardia

19
Q

How do Adrenergic Drugs?

A

To stimulate activity in the tissues that are affected by epinephrine and NE or to inhibit activity in the tissues

20
Q

Adrenergic Stimulants/Agonists

A

Stimulate sympathetic nervous system responses

21
Q

Other names for adrenergic agonists and adrenergic antagonists

A

-Adrenergic agonists: sympathomimetics
-Adrenergic Antagonists: sympatholytics

22
Q

What disorders do Adrenergic Drugs treat?

A

-common cold
-HTN
-angina
-asthma

23
Q

What are the different Adrenergic Receptors?

A
  1. Alpha:
    -Alpha-1
    -Alpha-2
  2. Beta:
    -Beta-1
    -Beta-2
    -Beta-3
24
Q

Which Adrenergic drugs can bind to which adrenergic receptors?

A

-some drugs only bind to one receptor subtype (very specific)
-some drugs will bind to either all alpha receptors or all beta receptors
-some drugs will bind to all alpha and beta receptors (not specific at all)

25
Q

Location & Action of Alpha-1 Selective Agonist receptors

A

-receptors located primarily in smooth muscle
-causes smooth muscle contraction and vasoconstriction

26
Q

What are Alpha-1 Selective Agonists used for?

A

-hypotension
-nasal congestion
-decreases HR during supraventricular tachycardia

27
Q

Side effects of Alpha-1 selective agonists?

A

-increased BP
-HA
-decreased HR
-chest pain
-difficulty breathing
-nervousness

28
Q

Location of Alpha-2 Selective Agonist Receptors?

A

-receptors located primarily at CNS synapses: brain and SC

29
Q

Uses and side effects of alpha-2 selective agonists

A

Treats:
-hypertension
-spasticity

Side effects:
-dizziness
-drowsiness
-dry mouth
-difficulty breathing
-slow HR
-fainting (indicates toxicity or overdose)

30
Q

Location and Action of Beta-1 selective agonist receptors

A

-receptors located on the myocardium
-stimulation causes increased HR and increased force of myocardial contraction

31
Q

Uses of Beta-1 selective agonists

A

-increases cardiac output in emergency situations
-used for short term management of CHF

32
Q

Side effects of beta-1 selective agonists

A

-chest pain
-cardiac arrhythmias
-SOB
-difficulty breathing

33
Q

Location and action of beta-2 selective agonist receptors

A

-receptors located on bronchiole smooth muscle
-causes bronchiole relaxation and dilation

34
Q

Uses of beta-2 selective agonists

A

Treats spasms and constriction associated with asthma, bronchitis, and emphysema

35
Q

Side effects of Beta-2 selective agonists

A

-nervousness
-restlessness
-trembling

36
Q

What are drugs with mixed alpha and beta agonist activity?

A

Drugs that can stimulate both alpha and beta receptors and mostly cause nervous system excitability
Examples: epinephrine and ephedrine

37
Q

Side effects of drugs with mixed alpha and beta agonist activity

A

-restlessness
-anxiety
-HTN
-arrhythmias

38
Q

How do Adrenergic Antagonists work?

A

They bind to adrenergic receptors and block them instead of activating them
-referred to as sympatholytic drugs since they block receptors that would normally cause sympathetic responses

**either alpha antagonists or beta antagonists

39
Q

Alpha Antagonists Action and Use

A

Reduces peripheral vascular tone or causes vasodilation by blocking receptors on vascular smooth muscle that normally causes vasoconstriction
-used to treat HTN by decreasing peripheral vascular resistance

40
Q

Side effects of Alpha Antagonists

A

Reflex tachycardia:
-when BP drops, the body compensates by increasing cardiac output and increasing HR
-orthostatic hypotension (after drug is first initiated)

41
Q

Beta Antagonists Action and Uses

A

-binds to beta-1 receptors located on the heart
-causes the force of contractions and HR to decrease since receptors have been blocked
-treats HTN, arrhythmias, angina, s/p MI, and CHF

**beta-blockers

42
Q

What is it called when beta-blockers only bind to beta-1 receptors?

A

cardioselective

43
Q

What happens if beta-blockers are not selective to beta-1 receptors?

A

Then those beta antagonists will bind to both beta-1 and beta-2 receptors which will also cause bronchoconstriction and smooth muscle contractions

44
Q

Beta Blocker Side Effects

A

-significant airway resistance in those with respiratory problems if they use a non-selective beta-blocker
-excessive depression of cardiac function
-orthostatic hypotension
-depression, lethargy, and sleep disorders
-blunted HR response to exercise

Pharm Exam II (9 decks)

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